Advisory Director, Payer Compliance – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.  

The Advisory Director, Payer Compliance – Remote is a leader within the Optum’s Payer Advisory Services, serving health care payer clients. The role requires a leader with proven healthcare consulting and operations exposure to and/or experience in developing business solutions as well as leading solution delivery with clients.

The Advisory Director, Payer Compliance – Remote is responsible for assisting health plans with compliance activities related to enabling an effective compliance program. Overall, the role will assist health plans with compliance program design, development, implementation and monitoring to ensure compliance with all applicable rules and regulations relating to the organization’s lines of business.

The role requires management consulting experience with business domain experience within Payer Compliance functions in one or more of the following capabilities:

• Develop strategies to promote and encourage a culture of compliance and coordination of the health plan’s compliance program with their business strategies and practices
• Focus on Fraud, Waste and Abuse (FWA)
• Engage with executive team and board for audit and compliance activities
• Engage in an external facing role with state and federal regulatory bodies

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Client Engagement Leadership and Delivery 
  • Establish trusted partner relationships to expand Optum’s footprint at designated clients
  • Drive client implementations of products, solutions and/or services
  • Drive/participate in presentations and meetings with C-suite and all levels of the organization
  • Direct responsibility for the delivery of mid-range to large scale client engagements, may include strategic management consulting, program or project delivery, workstream leadership, analysis or compliance support engagements. Large scale engagements are defined as high-cost, high complexity and/or high risk
  • Ensure high quality delivery of all engagements, client relationships and client delivery 
  • Management of multiple, concurrent client engagements, as required
  • Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies
  • Manage, coach and mentor resources within assigned engagements, as applicable, to promote, develop and retain talent
  • Ensure and deliver high quality verbal and/or written communication and artifacts 
• Market Planning and Thought Leadership:
  • Drive and/or participate in client sales processes and cycles
  • Drive and/or participate in the identification and development of consulting offerings, products, services and/or solutions that align with key market needs and or client initiatives
  • Define market needs & gaps to current capabilities (matrix with Marketing and Sales teams)
  • Research and formulate solutions to address fluctuating market conditions
  • Drive and/or conduct research studies, develop white papers and complete industry research for market and sales planning. May include collecting, analyzing, trending and presenting data and recommendations to management (Optum Advisory Services or client)
• Individual Accountabilities:
  • Effectively build and maintain high-quality, high value-add relationships with clients, teams, peers and partners
  • Drive NPS to achieve annual targets
  • Demonstrate and work with urgency to exceed client and/or customer expectations
  • Ensure sales and billable revenue targets are attained annually
  • Ensure utilization rate is attained annually 
  • Ensure practice development goals and targets are attained annually
  • Drive and lead practice and solution maturity and development opportunities
  • Drive practice success and deliver high value-add outcomes, with and without direct authority through demonstrating matrixed leadership

The consulting environment is challenging and fast-paced, requiring the following core competencies:

• Self-Motivated/Ambitious – Highly self-motivated and ambitious to ensure all engagements are successful
• Critical Thinking / Problem Solving – Dig into challenging situations, synthesizing information to provide guidance and recommendations to clients
• Adaptability – Flex in response to changes and maintain focus
• Creativity and Persuasiveness – Uncover and respond to business needs, define solutions, and educate constituents; be known by others as a trusted advisor
• Personal Accountability – Model strength during challenges and take personal responsibility for actions and consequences
• Executive Presence – Articulate and package communications in a clear and crisp manner for all levels of the organization with the ability to adapt approach and style to any audience
• Organization – Apply best practices for planning, executing and controlling work to maximize outcomes and value

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 10+ years of relevant health care work experience (health plan compliance and audit, health plan operations, health care insurance, or health care management consulting)
• 5+ years demonstrated program, project and/or team leadership experience with customer or client facing accountabilities
• 5+ years of experience across multiple lines of health care Payer lines of business, including Commercial, Medicare, Medicaid, ACA and Family/Individual coverage, among others
• Demonstrated experience in customer or client relationship management
• Proven experience in data analysis and financial analysis 
• Proven business development experience and success generating at least $1.5M+ annually in new sales
• Proven ability to work in complex, highly matrixed fast-paced environments
• Proven solid interpersonal and relationship management skills 
• Proven analytical problem-solving skills (identification of issue, causes, solution, implementation plan) 
• Demonstrated, solid communication (verbal, written) and presentation skills
• Demonstrated program and operational coordination and management skills – solid tracking, presentation and reporting skills 
• Ability to travel up to 50%; travel is required for this role and is generally less than 50% on average and might be required for short periods to satisfy specific client project requirements

Preferred Qualifications:

• Master’s Degree in business related field
• Certified in Healthcare Compliance (CHC) Certification
• Experience with AI-enabled compliance solutions
• Proven solid ability to influence and motivate cross functional teams

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.